Enjoyment Of Life Research Articles

Feasibility, acceptability, and initial outcomes of a psychological adjustment and reintegration program for transitioned military veterans

BackgroundReintegration and adjustment to civilian life after military service is crucial for veterans’ mental and physical health. However, there is a lack of evidence-based interventions in Australia that specifically address the psychological and cultural factors associated with improved adjustment and mental health in this group. The aim of this study was to evaluate the feasibility, acceptability, and initial outcomes of a novel group intervention program, developed to address this gap in supports and services for Australian veterans.MethodsA non-controlled, within-subjects longitudinal design was employed with a feasibility framework including assessment of demand, implementation, integration, experience, perceived effectiveness, and burden or discomfort. The program included eight weekly 2.5-hour group sessions using cognitive-behavioural and acceptance and commitment therapy techniques. Participants included 24 transitioned veterans who completed the Military-Civilian Adjustment and Reintegration Measure, Quality of Life Enjoyment and Satisfaction Questionnaire–Short Form, Depression Anxiety Stress Scale-21, and PTSD Checklist for DSM-5 at pre-intervention, post-intervention, and three-month follow-up.ResultsHigh participant ratings of engagement, experience and usefulness of the program were found, as well as perceived improvement in adjustment to civilian life as a result of the program. Sound program retention (82.8%), completion (87.5%), and manual adherence rates (89.6%) were also found. Significant improvements were found in adjustment and reintegration scores from pre-intervention to post-intervention (p = < 0.001) and from pre-intervention to follow-up (p = < 0.05), with large effect size (ηp2 = 0.344). All participants who completed the program reported they would recommend the program to another veteran.ConclusionThis study demonstrated the feasibility and acceptability of a novel group intervention program designed for military veterans in Australia. The program showed promising initial evidence of effectiveness in improving adjustment and reintegration to civilian life and provides an essential first step towards addressing a substantial gap in services for veterans struggling to adjust to civilian life. A randomised controlled trial may be an appropriate next step.ANZCTR registration numberACTRN12622000172707.Date of registration02/02/2022.Type of registrationRetrospectively registered.

Quality of Life and Symptoms of Hospitalized Hematological Cancer Patients

Patients with hematological malignancies undergo intensive treatment and prolonged hospitalization, thus having a variety of physical and psychosocial symptoms and worse quality of life (QOL). This study aimed to assess the QOL and investigate the symptoms of hospitalized hematological cancer patients. A cross-sectional study was conducted in the hematology clinics and day units of two general hospitals of Heraklion, Crete. Adult patients with hematological malignancy and an adequate understanding of the Greek language participated. A demographic questionnaire, the European Organization for Research and Treatment for Cancer quality assessment questionnaire (EORTC QLQ-C30), and the MD Anderson Symptom Inventory (MDASI) were used. The sample consisted of 120 patients—42.5% were women, with a mean age of 65.6 years. The mean time from diagnosis was 33 months. The global health status of QoL had an average value of 47.1. The highest levels of QOL were found in the subscale of cognitive function (72.8) and the lowest in the role function (46.1). For the EORTC QLQ-C30 symptoms scale, the lowest score was found in nausea-vomiting (11.0) and the highest in fatigue (59.1). In the MDASI, in part I (core symptoms), higher levels but also medium intensities were reported at fatigue (78.3%, mean 3.5), drowsiness (65.0, mean 3.3), and distress (65.8%, mean 2.8). In part II, enjoyment of life (85.8%, mean 5.1) had the highest, and relation with other people (67.5%, mean 3.7) had the lowest scores. The increase in the severity of the core symptoms (part I) was related to females (rho = 0.193, p &lt;0.05) and comorbidities (rho = 0.220, p &lt; 0.05). It was also associated with a significant decrease in all functional domains and increased fatigue (rho = 0.571, p &lt; 0.05) in the EORTC QLQ-C30 questionnaire. The increased global health status was related to males (rho = −0.185, p &lt; 0.05) and physical functioning with younger age (rho = −0.331, p &lt; 0.05), higher education (rho = 0.239, p &lt; 0.05), fewer months from diagnosis (rho = −0.199, p &lt; 0.05), and low comorbidity (rho = −0.209, p &lt; 0.05). Finally, multiple linear regression analysis revealed that the total average symptom score of the MDASI was the most significant factor influencing the global health status of the EORTC QLQ-C30 (β = −4.91, p &lt; 0.001). The increased global health status of the EORTC QLQ C30 was not significantly related (p &gt; 0.05) to the social characteristics of the patients, such as education or employment, which requires further validation. The QoL of hematological cancer patients significantly decreases during treatments due to a considerable number of symptoms that must be taken into consideration for high-quality, individualized care.

A pilot randomized controlled trial of a virtual peer-support exercise intervention for female older adults with cancer

BackgroundRegular exercise can mitigate side effects of cancer treatment. However, only a small proportion of adults with cancer meet exercise guidelines, and older adults (> 65 years) are underrepresented in cancer rehabilitation research. Peer support facilitates health-promoting behaviours in general populations, but interventions merging exercise and peer support for older adults with cancer are not examined. The purpose of this study was to determine the feasibility and preliminary effectiveness of a virtual partner-based peer support exercise intervention for older adult female cancer survivors.MethodsOlder adult female cancer survivors with internet access and currently participating in < 150 min of moderate-vigorous physical activity per week were included in this study. Participants were matched with a partner and given a peer support guide, exercise guidelines, and a Fitbit Inspire©. In addition, intervention group dyads (AgeMatchPLUS) had weekly 1-h virtual sessions with a qualified exercise professional for 10 weeks. Dyads randomized to the control group (AgeMatch) independently supported their partner around exercise for 10 weeks. The primary outcome was feasibility, measured using retention and adherence rates. Secondary outcomes included exercise volume, social support, quality of life, physical function, and physical activity enjoyment. Descriptive statistics were used to report feasibility and an ANCOVA was used to explore between group differences on secondary outcomes at post-intervention (10 weeks post baseline) and post-tapering timepoints (14 weeks post baseline).ResultsEighteen participants (9 dyads; mean age 72 years (SD: 5.7 years)) were included in the pilot trial. Retention and adherence rates to the AgeMatchPLUS intervention were 100% and 95% respectively. All but one participant was satisfied with the quality of their peer match. Preliminary effects were seen between group, favouring AgeMatchPLUS for exercise-related social support post-intervention (effect size (d) = 0.27, 95% CI = 0,0.54) and physical activity enjoyment at post-tapering (d = 0.25, 95% CI = 0,0.52) and favouring the AgeMatch group for 30 s sit-to-stand repetitions at post-tapering (d = 0.31, 95% CI = 0.004, 0.57). No other effects were found.ConclusionsA virtual partner-based exercise intervention for older adults with cancer is feasible and shows preliminary effect benefits. Findings inform future trials aimed at increasing exercise in older adults with cancer.Trial registrationClinicaltrials.gov (ID: NCT05549479, date: 22/09/22).

Brain encoding during perceived control as a prospective predictor of improvement in quality of life.

Perceived control is strongly related to mental health and well-being. Specifically, lack of perceived control has been associated with learned helplessness and stress-related disorders, such as depression and anxiety. However, it is unknown whether brain activation to control and its protective effect against stress can predict changes in quality of life. To address this gap, we examined the neural underpinning of controllability in healthy females (N=40) performing the Value of Control task in an fMRI scanner. Quality of life and perceived stress were assessed at baseline and 6-month follow-up. Increased brain activation for control was found within the putamen, insula, thalamus, mid-cingulate, dorsolateral prefrontal cortex, motor cortex, and cerebellum. In contrast, increased brain activation for lack of control was found within the posterior cingulate and prefrontal cortices. In an exploratory analysis, an elastic-net algorithm was used to identify brain predictors of quality of life 6 months later. The right putamen's activation to control was selected as the best prospective predictor of improvement in life enjoyment and satisfaction and this association was mediated by changes in perceived stress. Our findings suggest that neural responsiveness to control may have utility as a potential marker of quality of life and resilience to adversity.

Reclassification of items in the Leicester Cough Questionnaire: Correlation analysis

BackgroundThe Leicester Cough Questionnaire (LCQ) is a validated tool for assessing cough that has three domains (physical, psychological, and social), with eight, seven, and four items, respectively. However, the assigned domain may not accurately reflect the characteristics of an item. This study aimed to reclassify the items in the Korean version of the LCQ (K-LCQ) to improve the coherence in each domain. MethodsData of patients with chronic cough from 16 centers who completed the K-LCQ were retrospectively analyzed. Spearman’s rank correlation analysis was used to assess the correlations between items and their domains. Principal component analysis was performed to recategorize the K-LCQ items. ResultsThe correlation analysis of the data from 255 patients demonstrated that certain items such as tiredness, embarrassment, and interference with daily work or overall life enjoyment showed strong or very strong correlations with all three domains. Cough bout frequency showed the weakest correlation with the physical domain, despite being included in that domain, and had stronger correlations with the psychological and social domain. The principal component analysis led to the reclassification of six items: one from the physical to psychological, two from the social to psychological, and three from the psychological to social domain. The within-domain correlation coherence was higher in the new classification than in the original. Validation using an independent cohort of 203 patients yielded similar results. ConclusionsThe new classification of the K-LCQ items showed improved within-domain correlation coherence.

Targeting chronic pain care to rural women veterans: A feasibility pilot.

For rural women veterans, significant barriers exist in accessing high-quality, multicomponent behavioral pain self-management interventions. As such, a telehealth behavioral pain self-management intervention designed specifically for rural-dwelling women veterans with chronic pain was piloted for this study. This mixed methods, single-arm preliminary study examined the feasibility and acceptability of this intervention and completed a responder analysis. Participants completed surveys before and 1-month following the intervention, and they completed a qualitative interview following the intervention. About one quarter (24%) of potentially eligible participants who were sent a letter about the study consented to participate (N = 44). All participants identified as female and were rural dwelling, with mean age of 56 years (range = 34-80), and the majority of the sample (81%) self-identified as White and non-Hispanic or Latino. Average baseline scores on the Pain, Enjoyment of Life, and General Activity three-item scale (PEG-3) measure indicated severe pain and functional interference (MPEG-3 total = 6.88, SD = 1.62). Of the 44 participants who consented, 70% completed the intervention. About half of treatment completers (47%, 14/30) were deemed responders, reporting ≥ 30% reduction on their PEG-3 total scores. On the Global Impression of Change scale, 87% reported improvement. Study completers indicated that the telehealth platform facilitated their engagement and that they perceived the intervention to be beneficial and credible. Qualitative data emphasized themes of connection with other women veterans who experienced chronic pain while perceiving a retained sense of individual identity. These preliminary data support feasibly of this intervention for rural-dwelling women veterans with chronic pain. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Using network analysis to provide evidence for brain health as a unified construct relevant to aging with HIV.

Brain health is a dynamic state involving cognitive, emotional, and motor domains. Measuring brain health is a challenge owing to the uncertainty as to whether it is one or many constructs. This study aimed to contribute evidence for brain health as a unified construct by estimating the strength of relationships between and among patient-reported items related to the brain health construct in a population with brain vulnerability owing to HIV. Data for this cross-sectional analysis came from a Canadian cohort of people aging with HIV. The sample included 710 men recruited between 2014 and 2016 from five Canadian cities. A network analysis was conducted with 30 items selected from the brain-related domains of fatigue, cognition, depression, sleep, anxiety, and motivation. Node centrality measures were used to determine the most critical items in the network. The network showed small-world properties, that is, most nodes can be reached from other nodes with few hops," indicating strong connectivity. The most central symptoms were "How much do you enjoy life?" and "How often do you have negative feelings?". The small-world properties of the network structure indicate that brain health items are interconnected and may be influenced by shared underlying factors. The centrality indices suggest that items related to enjoyment of life and negative feelings may be particularly important for understanding brain health in this population. Future research should aim to replicate these findings in larger and more diverse samples to confirm their robustness and generalizability.

Quality of life and interpersonal support among adult patients with cancer undergoing chemotherapy at an academic cancer institute.

370 Background: The National Cancer Institute (NCI) defines quality of life (QOL) as “overall enjoyment of life.” Increasingly, cancer treatments like chemotherapy are focused on not only increasing survival time but on maintaining and/or improving QOL. Interpersonal support has been shown to have an impact on QOL. Assessment of both can help focus efforts to improve quality of care for cancer patients. Methods: This study enrolled patients from the Lifespan Cancer Institute at The Miriam Hospital (TMH) in Rhode Island who were adults 18+ and on chemotherapy infusion treatment with an active cancer diagnosis. Patients were randomly selected for an in-person interview during scheduled chemotherapy infusion appointments from February 9 to April 26, 2024. We collected patient demographics and study staff administered the 16-item Quality of Life Scale (QOLS) and 12-item Interpersonal Support Evaluation List (ISEL). Results: Of 432 total eligible cancer patients at TMH, 96 (22%) completed the prospective survey. The average (SD) age was 68.4 years old (10.3). The majority of patients were male (51%), Caucasian (80%), married (65%), on Medicare (62%), diagnosed in 2023 or 2024 (59%), and the most common cancers were gastrointestinal (30%), genitourinary (24%), and breast (17%). Overall, patients demonstrate mostly high satisfaction in certain QOL and interpersonal support domains with variation across others. Over 80% of patients are “delighted” or “pleased” with their material comforts, close family and friends, entertainment, and independence. However, approximately 50% of patients report a mixed or worse level of satisfaction with their health, participation in organizations/public affairs, and active recreation and varying levels of satisfaction with other QOL domains. Over 60% of patients report the highest level of perceived interpersonal support across all domains (appraisal, belonging, tangible) with indication of stronger appraisal support compared to belonging and tangible. Conclusions: Our results indicate a strong satisfaction among patients with their close interpersonal networks rather than external affairs or activities. Satisfaction with health and active recreation among chemotherapy patients is much more variable. These findings suggest possible benefits of wellness and health maintenance programs during treatment. Lowest areas of interpersonal support indicate a need to build more comprehensive support resources for tangible tasks like moving, assisting with chores, or other physical activities and building support groups to increase belonging. Opportunities to build community among chemotherapy patients or utilize clinical social workers will likely improve satisfaction in many of the more low and variable QOL and interpersonal support domains, particularly for patients navigating a new or first-ever cancer diagnosis.

Strategies to Deimplement Opioid Prescribing in Primary Care

Centers for Disease Control and Prevention guidelines advocate reduced opioid prescribing for chronic pain, yet research on their implementation remains limited. To compare 4 deimplementation strategies to promote guideline-concordant opioid prescribing. This cluster randomized clinical trial was performed at 32 primary care clinics from 2 US health care systems from February 2020 to March 2022, using a hybrid type 3 sequential multiple-assignment design focused on patient outcomes. Clinics were recruited through volunteer sampling, including 268 clinicians and 8978 patients. Data were analyzed from September 2020 to March 2022. Deimplementation strategies were targeted at the system, clinic, and prescriber levels. All clinics received a system-level strategy consisting of quarterly educational meetings with monthly audit and feedback (EMAF) reports. At month 3, half the clinics were randomized to receive practice facilitation (PF), a clinic-level strategy that targets clinic workflows. At month 9, half the clinics were again randomized to add prescriber peer consulting (PPC), a prescriber-level strategy focused on challenging patient cases. The primary outcome was change in mean morphine milligram equivalent (MME) dose in clinics receiving the least intensive bundle of deimplementation strategies (EMAF) vs the most intensive (EMAF plus PF plus PPC). Secondary outcomes included adherence to guideline metrics aimed at mitigating opioid risk. Among the 8978 patients included in the analysis, 5142 (57.3%) were female; 42 (0.5%), American Indian or Alaska Native; 74 (0.8%), Asian or Pacific Islander; 411 (4.6%), Black; 187 (2.1%), Hispanic or Latino; 8127 (90.5%), White; and 137 (1.5%), other or unknown. Mean (SD) age was 58.3 (14.3) years. Eight clinics (including 66 prescibers and 2044 patients) assigned the most intensive strategy (EMAF plus PF plus PPC) had statistically significant effects on the primary outcome compared with 7 clinics (including 60 clinicians and 2427 patients) receiving the least intensive strategy (EMAF); clinics in the high-intensity group decreased the mean MME dose by 2.4 (95% CI, -4.3 to -0.5) mg/d more than the EMAF group (P = .02), representing a 6% reduction, and increased screening for pain severity, enjoyment of life, and general activity by 5.4% (95% CI, 0.4%-10.4% [P = .04]) more. Compared with EMAF, the most intensive strategy resulted in statistically significant decreases in urine drug screening (difference, -7.3% [95% CI, -11.5% to -3.0%]; P < .001) and use of treatment agreements (difference, -6.7% [95% CI, -11.1 to -2.3%]; P = .003), in the opposite direction of the hypothesis. There were no significant differences between groups in benzodiazepine coprescribing, mental health screening, or patients receiving an MME dose greater than or equal to 90.0 mg/d. In this cluster randomized clinical trial, a high-intensity deimplementation strategy targeted at prescribers significantly decreased the MME dose and increased screening for pain intensity and pain-related interference while reducing use of treatment agreements and urine drug screening. Providing clinic- and prescriber-level deimplementation strategies may help health systems take positive steps toward reducing reliance on opioid medications for chronic pain management in primary care settings. ClinicalTrials.gov Identifier: NCT04044521.

Sustaining Joy in Serious Neurologic Illnesses.

The goals of medicine tend to be framed around addressing suffering, pathology, and functional deficits. While this is a natural orientation when dealing with serious illness, it is also incomplete and neglects significant opportunities to improve the quality of life of patients, families, and clinicians. The "total enjoyment of life" is a multidimensional framework that can serve as a positive counterbalance to the "total pain of illness." It allows clinicians, researchers, policymakers, and other stakeholders to take a systematic and comprehensive approach to the active promotion of well-being. The five opportunities for enhancing well-being in this framework are meaning, social connections, happiness/contentment, spiritual transcendence, and pleasure. Applying these concepts in clinical settings, patients, families, and clinicians can together find opportunities to increase the total enjoyment of life in the face of incurable and intractable illnesses. For family care partners, these concepts can be applied to improve self-care, enhance relationships, and develop more creative approaches to supporting a loved one living with illness. Clinicians working with these concepts may find their clinical work more satisfying and impactful and can also apply these concepts to their own lives to increase wellness. In clinical research, this framework can be applied to improve intervention effectiveness and relevance of outcome measures. Lastly, these concepts have the potential to impact public health approaches that focus on well-being and flourishing as the goal and metric of a healthy society.

Enhancing chronic low back pain management: an initial neuroimaging study of a mobile interoceptive attention training.

Chronic low back pain (cLBP) poses significant challenges, often addressed through avoidance or distraction. Emerging evidence suggests that mind-body interventions, like our novel Mind Your Pain (MyP) smartphone mobile application, may offer relief. We conducted a single-arm, mixed-methods neuroimaging study to assess the degree to which treatment response to our 8-week intervention, as measured by the reduction in the Pain, Enjoyment of Life and General Activity Scale (PEG), was associated with enhanced pain-related insula activation over time. Twenty-nine individuals with cLBP completed patient-reported assessments, qualitative sensory testing (QST) measures, and neuroimaging pre- and post-MyP. Functional MRI data during experimental heat pain on the left forearm were collected and analyzed, comparing responders (≥50% reduction in PEG scores) and non-responders. MyP led to significant decreases in PEG scores overall. Furthermore, MyP responders exhibited increased pain-related activation in key brain regions, including the contralateral posterior insula, bilateral ventral anterior insula, ventral anterior cingulate, dorsolateral prefrontal cortex, and nucleus accumbens. Although baseline behavioral and sensory measures did not differ between the two responder groups, baseline neural differences related to the impact of the endogenous back pain were observed. MyP appears to modify pain response and underlying neural circuitry, suggesting neural changes in interoception may serve as biomarkers for mind-body interventions in cLBP. This study highlights the potential of MyP as a novel approach for cLBP management, warranting further investigation.

Chronic Low Back Pain Causal Risk Factors Identified by Mendelian Randomization: a Cross-Sectional Cohort Analysis.

There are a number of risk factors- from biological, psychological, and social domains- for non-specific chronic low back pain (cLBP). Many cLBP treatments target risk factors on the assumption that the targeted factor is not just associated with cLBP but is also a cause (i.e, a causal risk factor). In most cases this is a strong assumption, primarily due to the possibility of confounding variables. False assumptions about the causal relationships between risk factors and cLBP likely contribute to the generally marginal results from cLBP treatments. The objectives of this study were to a) using rigorous confounding control compare associations between modifiable causal risk factors identified by Mendelian randomization (MR) studies with associations in a cLBP population and b) estimate the association of these risk factors with cLBP outcomes. Cross sectional analysis of a longitudinal, online, observational study. 1,376 participants in BACKHOME, a longitudinal observational e-Cohort of U.S. adults with cLBP that is part of the NIH Back Pain Consortium (BACPAC) Research Program. Pain, Enjoyment of Life, and General Activity (PEG) Scale. Five risk factors were selected based on evidence from MR randomization studies: sleep disturbance, depression, BMI, alcohol use, and smoking status. Confounders were identified using the ESC-DAG approach, a rigorous method for building directed acyclic graphs based on causal criteria. Strong evidence for confounding was found for age, female sex, education, relationship status, financial strain, anxiety, fear avoidance and catastrophizing. These variables were used to determine the adjustment sets for the primary analysis. Potential confounders with weaker evidence were used for a sensitivity analysis. Participants had the following characteristics: age 54.9 ± 14.4 years, 67.4% female, 60% never smokers, 29.9% overweight, 39.5% obese, PROMIS sleep disturbance T-score 54.8 ± 8.0, PROMIS depression T-score 52.6 ± 10.1, Fear-avoidance Beliefs Questionnaire 11.6 ± 5.9, Patient Catastrophizing Scale 4.5 ± 2.6, PEG 4.4 ± 2.2. In the adjusted models alcohol use, sleep disturbance, depression, and obesity were associated with PEG, after adjusting for confounding variables identified via a DAG constructed using a rigorous protocol. The adjusted effect estimates- the expected change in the PEG outcome for every standard deviation increase or decrease in the exposure (or category shift for categorical exposures) were the largest for sleep disturbance and obesity. Each SD increase in the PROMIS sleep disturbance T-score resulted in a mean 0.77 (95% CI: 0.66, 0.88) point increase in baseline PEG score. Compared to participants with normal BMI, adjusted mean PEG score was slightly higher by 0.37 points (95% CI: 0.09, 0.65) for overweight participants, about 0.8 to 0.9 points higher for those in obesity classes I and II, and 1.39 (95% CI: 0.98, 1.80) points higher for the most obese participants. Each SD increase in the PROMIS depression T-score was associated with a mean 0.28 (95% CI: 0.17, 0.40) point increase in baseline PEG score, while each SD decrease in number of alcoholic drinks per week resulted in a mean 0.12 (95%CI: 0.01, 0.23) increase in baseline PEG score in the adjusted model. Several modifiable causal risk factors for cLBP - alcohol use, sleep disturbance, depression, and obesity- are associated with PEG, after adjusting for confounding variables identified via a DAG constructed using a rigorous protocol. Convergence of our findings for sleep disturbance, depression, and obesity with the results from MR studies, which have different designs and biases, strengthens the evidence for causal relationships between these risk factors and cLBP (1). The estimated effect of change in a risk factors on change in PEG were the largest for sleep disturbance and obesity. Future analyses will evaluate these relationships with longitudinal data.

The Joint Enjoyment of Life. Explaining High Happiness in Latin America

The Joint Enjoyment of Life. Explaining High Happiness in Latin America

Is Being Single Ok? Analysis of College Students' Conditions of Being Single from a Gender Perspective

&lt;p&gt;基於發展階段的任務與社會文化期待，大學生面對高唱「脫單」、「脫魯」的氛圍，往往面臨是否進入戀愛關係的壓力。本研究從性別觀點探討單身大學生面對單身的認知、態度、情緒及其性別差異，以及人際互動與社會文化因素如何影響個人心理的性別差異。本研究採主位觀點自編問卷，進行網路調查，參與者為1,157位單身大學生。單身過去被視為失敗的象徵，本研究顯示，現今大學生對於單身的想法已較為多元，因素分析及多元迴歸的結果顯示，除了單身焦慮情緒及歸咎於己外，還出現享受單身的因素，且存在性別差異。平行中介分析結果顯示，單身男大生的單身焦慮高於單身女大生，也較容易將單身歸咎於己，這些性別差異被「受同儕影響而感到形單影隻」的人際互動因素完全中介。單身女大生較單身男大生更能享受單身，此性別差異被人際互動和社會文化因素部分中介，部分是因為單身女大生較不會受同儕影響感到形單影隻，部分是因為較未感受到社會文化的單身烙印。本研究顯示，在人際網絡與社會文化構築的壓力網下，單身女大生較能從傳統性別規範中解放出來。最後，本研究針對正向單身論述、男性情感教育、父母及同儕的影響提出建議；並討論未來採取量化和質性研究的方向，期能促進單身者的心理健康。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Romantic relationships are regarded as a milestone in college students’ developmental stage. Additionally, society and college culture demand that they leave their single status. College students visiting counseling centers commonly talk about romantic relationship problems. In response to college culture that emphasizes engagement in romantic relationships, college students are frequently troubled by the stress of being single when failing to meet this social and cultural expectation. However, research on singlehood has been neglected. This study explored college students’ emotions, attitudes, and cognitions regarding their singlehood and examined sex differences in these psychological states. The effects of interpersonal interactions and sociocultural factors on individual psychological states and sex differences were also examined. A questionnaire was developed from an emic perspective, and the items were adapted from articles posted on the Dcard forum regarding experiences of single college students. Exploratory factor analysis was applied to these items at three levels, that is, individual psychological state, interpersonal interactions, and social culture. The questionnaire was administered online to 1,157 single college students. While singlehood was marked as a symbol of failure, exploratory factor analysis revealed that college students had diverse thoughts about singlehood, ranging from enjoyment to anxiety. To understand sex differences in individual psychological states, multiple regression analyses were conducted, with anxiety about being single, enjoyment of a single life, and attribution of single status to personal traits respectively as dependent variables, and sexual orientation and grade level as covariates. We hypothesized that sex differences in individual psychological states are mediated by interpersonal interactions and sociocultural factors. The results of the parallel mediation analysis are consistent with this hypothesis. Sex differences in individual psychological states are mediated by interpersonal and sociocultural factors. The results showed that male students are more anxious about being single and more likely to attribute singlehood to personal traits than female students. By contrast, female students were more able to enjoy their single lives than male students. Specifically, controlling for sexual orientation and grade level, the sex differences in anxiety about being single and attribution of single status to personal traits were fully accounted for by the interpersonal interaction factor &amp;quot;&amp;quot;a sense of loneliness due to peer pressure.&amp;quot;&amp;quot; The sex differences in enjoyment of single life were partially accounted for by the interpersonal interaction factor &amp;quot;&amp;quot;a sense of loneliness due to peer pressure&amp;quot;&amp;quot; and sociocultural factor &amp;quot;&amp;quot;social stigma about singlehood.&amp;quot;&amp;quot; This study shows that single female college students are better able to liberate themselves from the pressure of interpersonal networks and sociocultural factors. In conclusion, single male college students are more anxious about their single status and are more likely to make internal attributions because of the pressure caused by interpersonal networks, whereas single female college students are more able to free themselves from peer pressure and social stigma, therefore, enjoying their single lives. Based on the results, we propose suggestions for positive discourse on being single, providing relationship education and counseling for male students, and analyzing the effect of parents and peers on college students’ perspectives on being single. This study explored college students’ perspectives on being single and the impact of individual, interpersonal, and societal factors. To measure the psychological state of a single person, reliable and valid inventories, such as single anxiety, need to be developed. Additionally, qualitative research may provide a deeper contextual understanding of single individuals. Further quantitative and qualitative research is needed to gain insight into the promotion of the well-being of a rising single population.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Crosswalking 4 Pain Impact Measures in a Nationally Representative Sample of Adults With Back Pain

ObjectiveTo generate crosswalk equations and tables for 4 pain impact measures: the Impact Stratification Score (ISS), Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and the Pain, Enjoyment of Life and General Activity Scale (PEG). DesignCross-sectional survey assessing demographics and pain impact. Crosswalks were developed using item-response theory (IRT) cocalibrations and linear regressions between the ISS, ODI, RMDQ, and PEG. SettingOnline panel. ParticipantsPopulation-based sample of United States adults aged 18 and older. Eligibility criteria were reporting current back pain, not reporting 2 fake health conditions, and having data for 2 or more pain measures (N=1530; 37% of sample). Crosswalks were developed (n=1030) and cross-validated in a subsample of 500 participants (n=125 randomly sampled from each ISS quartile). InterventionsNot applicable. Main Outcome MeasuresISS, ODI, RMDQ, and the PEG. ResultsAssociations of the ISS with the PEG and ODI met the criteria for IRT cocalibration. Other measure pairs were crosswalked using regression. Associations were strongest between the PEG and the ISS (r=0.87, normalized mean absolute error [NMAE]=0.38) and between the ODI and the ISS (r=0.85, NMAE=0.39). Associations were weakest between the PEG and the RMDQ (r=0.69, R2=0.48, NMAE: 0.55-0.58). Regression equations and IRT accounted for 48%-64% of the variance (NMAE: 0.38-0.58) in corresponding pain measures in the cross-validation sample. ConclusionsThe crosswalks between the ISS and common legacy pain measures created in this study of a nationally representative sample of United States adults with back pain can be used to estimate 1 pain impact measure from another. Further evaluation in clinical samples is recommended.

322. IMPACT OF POSTOPERATIVE NUTRITIONAL SUPPORT MODES ON CLINICAL AND PATIENT-REPORTED OUTCOMES IN ENHANCED RECOVERY AFTER ESOPHAGECTOMY FOR CANCER

Abstract Background Enhanced Recovery After Surgery (ERAS) for esophagectomy has been demonstrated to be safe and effective. However, there is significant variation in the nutritional support treatment modes during the perioperative period. We have recently developed a novel ERAS nutritional support mode. In this study, we compared this new mode with the previous ERAS nutritional support treatment mode to assess their impact on clinical and Patient-Reported Outcomes (PROs), aiming to develop an optimal approach. Methods We enrolled 357 patients who underwent esophagectomy for esophageal thoracic cancer or esophagogastric junction cancer from June 2021 to August 2023. Two different ERAS nutritional support treatment protocols were used postoperatively: the control group previously received enteral nutrition by nasojejunal tube + parenteral nutrition + early oral diet after surgery, while the study group currently received parenteral nutrition + early oral diet. We compared the two groups in terms of clinical observation indicators, hematological analysis, serum protein changes and clinical outcomes. The comparison of quality of life on PROs was assessed using the MD Anderson Symptom Inventory. Symptom changes were analyzed using a mixed-effects model. Results A total of 324 patients successfully completed the ERAS nutritional support protocols. The success rates were 91% in the control group and 90.2% in the study group, with no statistically significant difference (p&amp;gt;0.05). The incidence of complications did not significantly differ between the two groups (p&amp;gt;0.05). Compared to the control group (n=223), the study group (n=101) significantly shortened the chest drain time (6.2±2.6 days vs. 6.6±1.5 days, p&amp;lt;0.05) and elevated the levels of serum total protein and albumin on the 4th postoperative day (53±5 g/L vs. 51±4 g/L, 30±2 g/L vs. 28±2 g/L, p&amp;lt;0.05). There were no statistically significant differences in the first flatus time, first defecation time, infusion time and postoperative hospital stay between the two groups (p&amp;gt;0.05). The comparison of hematological analysis, serum protein changes, changes in body weight during the perioperative period and 30-day readmission rate showed no statistically significant differences (p&amp;gt;0.05). In the MD Anderson Symptom Inventory, the study group had significantly better scores in sadness, dry mouth, enjoyment of life, and general activity dimensions compared to the control group (p=0.013, p&amp;lt;0.001, p=0.045, p=0.008). Conclusion Based on the similar rehabilitation outcomes, the simplified ERAS nutritional support treatment mode without postoperative enteral nutrition by nasojejunal tube is more optimized because it is physiological sound and significantly improves quality of life on PROs.

Associations between smoking history, baseline pain interference and symptom distribution, and physical function at discharge, in individuals seeking care for musculoskeletal pain

ObjectiveStudy of the association between smoking and pain intensity has produced conflicting results; with less focus on pain interference. Different pain constructs could have varying associations with smoking behaviors. This study sought to investigate the association between smoking history and not only pain intensity, but also pain interference, symptom distribution and physical function. MethodsSmoking history (current, past, or none), pain interference (Pain, Enjoyment of Life, and General Activity scale), symptom distribution and physical function scores were extracted from medical records of patients seen in physical therapy for common sites of musculoskeletal pain (lumbar and cervical spine, knee, or hip). Generalized linear models assessed the relationship between smoking history and pain/function. Results833 patients from an integrated healthcare system were included (mean: 57.6 years, SD=16.3; 43 % male). After controlling for several variables, current smokers had significantly higher baseline pain interference scores compared to never and former smokers (beta [B]: 0.65, 95 %CI: 0.13 to 1.18, P=.02). Smoking was not a significant predictor of symptom distribution at baseline [B: 0.17, 95 %CI −0.06 to 0.42, P=.16] or physical function scores at discharge [B: -0.03, 95 %CI: −0.08 to 0.02, P=.25]. ConclusionSmokers experienced a greater impact of pain at baseline. However, symptom distribution at intake and function upon discharge were similar between all smoking groups. These findings suggest smoking cessation and abstinence may be important recommendations to help curb pain interference.

Testing the religion/spirituality-mental health curvilinear hypothesis using data from many-analysts religion project

ABSTRACT Findings from the recent Many-Analysts Religion Project (MARP) have been characterized as supporting a robust positive relationship between various measures of religion and aspects of well-being. However different conceptualizations of religiosity (e.g. identity, attendance, belief, conviction) can theoretically be expected to display distinct (e.g. non-linear or curvilinear) patterns of relationships with different manifestations of well-being. Additionally extant analyses of MARP data have not addressed how influences such as social support affect the relationship between religion/spirituality (R/S) and well-being. The present analysis restricted to a subset of countries with the predominant religion of Christianity found that net demographic controls, meaning in life, and enjoyment of life was significantly higher among those identifying as religious, attending religious service, and identifying as believing in God. However, when God was modelled quadratically, both meaning in life and enjoyment of life demonstrated a “J-shaped” relationship, although the nuances for their interpretation were distinct. Thus, partial support was found for a quadradic or “J-shaped” relationship between religious belief and mental well-being. Finally, adjusting estimates for social support tended to diminish the importance of R/S variables for predicting well-being, suggesting that increased well-being evinces a complex relationship with religious belief.

Identifying associations between sample characteristics, symptoms, and self-efficacy differences in adult patients with rare tumors of the central nervous system who participated in a novel web-based natural history study.

High self-efficacy is associated with improved self-care and reduced symptoms in cancer patients but has not been fully interrogated in adults with central nervous system (CNS) cancers. We aimed to identify the relationship between self-efficacy levels in managing emotions (SEMEM) and social interactions (SEMSI) by examining sample characteristics and symptom burden. Sample characteristics and patient-reported outcome (PRO) measures addressing self-efficacy (PROMIS SEMEM & SEMSI) and symptom burden (MDASI BT or SP) were collected in a novel web-based study of 158 adult patients diagnosed with rare CNS tumors. The sample was predominantly female (73%), diagnosed with an ependymoma (66%), and had a median age of 45 (19-75). Low SEMEM was associated with a longer duration of symptoms before surgery (r = -0.26) and female gender (92%) among brain tumor (BT) participants and in spinal cord tumors (SCT), those with lower education (r = 0.29). Reporting low SEMSI was associated with being married (42%), lower education (r = 0.22), and a prolonged time with symptoms before surgery (r = 0.29) in those with BTs, with no associations identified in SCT. More severe mood-related interference (including mood, enjoyment of life, and relationship with others) was associated with lower SEMEM among both locations (r = -0.61 brain, r = -0.28 spine) and SEMSI in BT participants (r = -0.54). Low self-efficacy was linked to a prolonged time between symptom onset and initial surgery, education, gender, and marital status and was associated with higher mood-related interference. Understanding characteristics associated with low self-efficacy underscores a need for future studies to tailor interventions that enhance self-efficacy.

Relationship Between Sexual Dysfunction and Quality of Life in Psychiatric Patients Receiving Regular Treatment: A Cross-Sectional Study.

Sexual dysfunction (SD) is a significant issue among psychiatric patients on psychotropic medications. This study aims to compare SD in patients using antipsychotics and antidepressants. To evaluate the prevalence of SD and its effect on the quality of life among psychiatric patients on medications. A cross-sectional study had been conducted with 150 participants (50 with schizophrenia, 50 with affective disorders, and 50 controls). SD was evaluated employing the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ) and the Arizona Sexual Experience Scale (ASEX). The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) was used to measure the quality of life. Data analysis techniques included Spearman's correlation test, one-way ANOVA, chi-square test, and descriptive statistics. SD prevalence was 42% in affective disorders, 64% in schizophrenia, and 18% in controls. SD significantly correlated with a longer duration of psychotropic use and negatively impacted quality of life. SD is prevalent among psychiatric patients on long-term medication, highlighting the need for strategies to manage these side effects.